Cochrane · systematic review · CD013581
Non‐steroidal anti‐inflammatory drugs for acute low back pain
van der Gaag, WH, Roelofs, PDDM, Enthoven, WTM, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Back and NeckAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
10
current version
GRADE rated
9
No studies
1
Included studies
NR
No studies 1 · 10%Ungraded 0 · 0%Very low 3 · 30%Low 3 · 30%Moderate 2 · 20%High 1 · 10%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
NSAIDs compared to placebo in people with acute low back pain
Population: adults (≥ 18 years of age) with acute low back pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity VAS (0 to 100; lower = better) NSAIDs vs placebo | no estimate extracted | 4 studies · 815 participants | Moderate Downgraded: risk of bias |
Disability RMDQ (0 to 24; lower = better) NSAIDs vs placebo | no estimate extracted | 2 studies · 471 participants | High |
Proportion of participants experiencing global improvement Various dichotomised Likert scales; lower = better NSAIDs vs placebo | RR 1.4 [1.12, 1.75] | 5 studies · 1201 participants | Low Downgraded: inconsistency, indirectness |
Proportion of participants experiencing adverse events NSAIDs vs placebo | RR 0.86 [0.63, 1.18] | 6 studies · 1394 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Return to work (%) NSAIDs vs placebo | RR 1.48 [0.98, 2.23] | 1 study · 266 participants | Very low Downgraded: risk of bias, imprecision |
Selective COX‐2 inhibitors compared to non‐selective NSAIDs for acute low back pain
Population: adults (≥ 18 years of age) with acute low back pain (LBP)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in pain intensity from baseline VAS (0 to 100; lower = better) Selective COX‐2 inhibitors vs non‐selective NSAIDs | no estimate extracted | 2 studies · 437 participants | Low Downgraded: risk of bias, inconsistency |
Disability ODI (0 to 50; lower = better) Selective COX‐2 inhibitors vs non‐selective NSAIDs | no estimate extracted | 2 studies · 437 participants | Moderate Downgraded: risk of bias |
Proportion of participants experiencing global improvement % of dichotomized Likert scale Selective COX‐2 inhibitors vs non‐selective NSAIDs | no estimate extracted | 1 study · 333 participants | Low Downgraded: risk of bias, imprecision |
Proportion of participants experiencing adverse events Selective COX‐2 inhibitors vs non‐selective NSAIDs | RR 0.97 [0.63, 1.5] | 2 studies · 444 participants | Very low Downgraded: risk of bias, imprecision |
Return to work (%) Selective COX‐2 inhibitors vs non‐selective NSAIDs | no estimate extracted | NR | No studies |